Use of pronator quadratus pedicle vascularized bone graft with headless compression screw in nonunion scaphoid fractures

Objective: To evaluate the effectiveness of the vascularized muscle pedicle bone graft technique for achieving healing in nonunion scaphoid fracture cases. Methodology: This prospective study was conducted from 2017 to 2019 and inckuded 25 patients with scaphoid fractures with nonunion evaluated radiological. The procedure was done under general anesthesia in which a pedicle vascularize pronator quadrats vascularized graft taken from the radius was placed at the site of nonunion and fixed with a headless compression screw with a guide wire. Patients were assessed both clinically and radiologically every four weeks for 25 weeks Results: Out of 25 patients, 19 (76%) were males and 6 (24%) were females. Eight (32%) had fracture of the proximal pole of the scaphoid whereas 17 (68%) had fracture of the waist of the scaphoid. The mean duration of the bony union was 12.4 +/- 2.3 weeks. The mean grip strength increased by 28% after the union, while the mean preoperative VAS score (which was 45.3 +/- 5.2 initially) decreased to a mean of 20.3 +/- 7.9 after the bony union. Conclusion: The use of a headless screw along with a vascularized pedicle pronator quadratus graft provided high chances of the union in scaphoid fractures.